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. 1985 Sep;26(9):935–944. doi: 10.1136/gut.26.9.935

Pathology of the alimentary tract in Salmonella typhimurium food poisoning.

J F Boyd
PMCID: PMC1432849  PMID: 3896961

Abstract

The pathology of the alimentary tracts of nine patients dying of Salmonella typhimurium infection is reviewed. Two patients had previous gastric operations, supporting previous reports that such patients are more susceptible to food poisoning. Four had no parietal (oxyntic) cells in the gastric mucosa, suggesting hypo- or anacidity. Only one had acute gastritis. None had acute enteritis, but in half of the patients, subtle histological changes suggested an 'enteropathy'. Acute diffuse colitis with abundant crypt abscesses, without stromal abscesses in the lamina propria, was the most constant finding and reparative features started very early, and occurred in later deaths. Under ideal circumstances this crypt abscess is readily distinguished from that of idiopathic ulcerative colitis, but can be confused with the crypt abscess of acute bacillary (sonne) dysentery. While the florid colonic changes may have settled in the late deaths, active inflammation is commonly present in the appendix mucosa on histology. The pathology of the alimentary tract in S typhimurium infection differs from that of S typhi and S paratyphi infections. There is little evidence of gastroenteritis, although subtle changes occur in the stomach and small intestine. The features are those of acute diffuse colitis with histological appendicitis, distinguishable from idiopathic ulcerative colitis.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Axon A. T., Poole D. Salmonellosis presenting with cholera-like diarrhoea. Lancet. 1973 Apr 7;1(7806):745–746. doi: 10.1016/s0140-6736(73)92129-6. [DOI] [PubMed] [Google Scholar]
  2. Boyd J. F. Letter: Colonic involvement in salmonellosis. Lancet. 1976 Jun 26;1(7974):1415–1415. doi: 10.1016/s0140-6736(76)93070-1. [DOI] [PubMed] [Google Scholar]
  3. Boyd J. F. Salmonella typhimurium, colitis, and pancreatitis. Lancet. 1969 Oct 25;2(7626):901–902. doi: 10.1016/s0140-6736(69)92352-6. [DOI] [PubMed] [Google Scholar]
  4. DANIELS J. J. Enteric infections with Pasteurella pseudotuberculosis. An acute abdominal syndrome. J Int Coll Surg. 1962 Nov;38:397–411. [PubMed] [Google Scholar]
  5. Dadswell J. V. Acute appendicitis and Salmonella infections. Br Med J. 1973 Mar 24;1(5855):740–740. doi: 10.1136/bmj.1.5855.740-b. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Day D. W., Mandal B. K., Morson B. C. The rectal biopsy appearances in Salmonella colitis. Histopathology. 1978 Mar;2(2):117–131. doi: 10.1111/j.1365-2559.1978.tb01700.x. [DOI] [PubMed] [Google Scholar]
  7. Dickinson R. J., Pickens S. Morbidity and mortality in salmonella food poisoning. A review of 47 in-patient cases. Scott Med J. 1978 Jan;23(1):23–26. doi: 10.1177/003693307802300107. [DOI] [PubMed] [Google Scholar]
  8. Dronfield M. W., Fletcher J., Langman M. J. Coincident salmonella infections and ulcerative colitis: problems of recognition and management. Br Med J. 1974 Jan 19;1(5898):99–100. doi: 10.1136/bmj.1.5898.99. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. El-Maraghi N. R., Mair N. S. The histopathology of enteric infection with Yersinia pseudotuberculosis. Am J Clin Pathol. 1979 Jun;71(6):631–639. doi: 10.1093/ajcp/71.6.631. [DOI] [PubMed] [Google Scholar]
  10. Elliott P. R., Williams C. B., Lennard-Jones J. E., Dawson A. M., Bartram C. I., Thomas B. M., Swarbrick E. T., Morson B. C. Colonoscopic diagnosis of minimal change colitis in patients with a normal sigmoidoscopy and normal air-contrast barium enema. Lancet. 1982 Mar 20;1(8273):650–651. doi: 10.1016/s0140-6736(82)92203-6. [DOI] [PubMed] [Google Scholar]
  11. GANGAROSA E. F., BEISEL W. R., BENYAJATI C., SPRINZ H., PIYARATN P. The nature of the gastrointestinal lesion in asiatic cholera and its relation to pathogenesis: a biopsy study. Am J Trop Med Hyg. 1960 Mar;9:125–135. doi: 10.4269/ajtmh.1960.9.125. [DOI] [PubMed] [Google Scholar]
  12. Giannella R. A., Broitman S. A., Zamcheck N. Salmonella enteritis. I. Role of reduced gastric secretion in pathogenesis. Am J Dig Dis. 1971 Nov;16(11):1000–1006. doi: 10.1007/BF02235012. [DOI] [PubMed] [Google Scholar]
  13. Giannella R. A., Broitman S. A., Zamcheck N. Salmonella enteritis. II. Fulminant diarrhea in and effects on the small intestine. Am J Dig Dis. 1971 Nov;16(11):1007–1013. doi: 10.1007/BF02235013. [DOI] [PubMed] [Google Scholar]
  14. Gray J. A., Trueman A. M. Severe salmonella gastroenteritis associated with hypochlorhydria. Scott Med J. 1971 May;16(5):255–258. doi: 10.1177/003693307101600504. [DOI] [PubMed] [Google Scholar]
  15. Green P. H., Middleton W. R. Salmonella typhimurium colitis. Aust N Z J Med. 1976 Aug;6(4):345–347. doi: 10.1111/imj.1976.6.4.345. [DOI] [PubMed] [Google Scholar]
  16. Jiwa S. F. Probing for enterotoxigenicity among the salmonellae: an evaluation of biological assays. J Clin Microbiol. 1981 Nov;14(5):463–472. doi: 10.1128/jcm.14.5.463-472.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
  17. KUNZ L. J., WADDELL W. R. Association of Salmonella enteritis with operations on the stomach. N Engl J Med. 1956 Sep 20;255(12):555–559. doi: 10.1056/NEJM195609202551203. [DOI] [PubMed] [Google Scholar]
  18. Kennedy D. H., Walker G. H., Fallon R. J., Boyd J. F., Gross R. J., Rowe B. An outbreak of infantile gastroenteritis due to E. coli 0142. J Clin Pathol. 1973 Oct;26(10):731–737. doi: 10.1136/jcp.26.10.731. [DOI] [PMC free article] [PubMed] [Google Scholar]
  19. Koo F. C., Peterson J. W., Houston C. W., Molina N. C. Pathogenesis of experimental salmonellosis: inhibition of protein synthesis by cytotoxin. Infect Immun. 1984 Jan;43(1):93–100. doi: 10.1128/iai.43.1.93-100.1984. [DOI] [PMC free article] [PubMed] [Google Scholar]
  20. Koupal L. R., Deibel R. H. Assay, characterization, and localization of an enterotoxin produced by Salmonella. Infect Immun. 1975 Jan;11(1):14–22. doi: 10.1128/iai.11.1.14-22.1975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  21. Mandal B. K., Mani V. Colonic involvement in salmonellosis. Lancet. 1976 Apr 24;1(7965):887–888. doi: 10.1016/s0140-6736(76)92100-0. [DOI] [PubMed] [Google Scholar]
  22. McGovern V. J., Slavutin L. J. Pathology of salmonella colitis. Am J Surg Pathol. 1979 Dec;3(6):483–490. doi: 10.1097/00000478-197912000-00001. [DOI] [PubMed] [Google Scholar]
  23. Mills P. R., Brown I. L., Watkinson G. Idiopathic chronic ulcerative enteritis. Report of five cases and review of the literature. Q J Med. 1980 Spring;49(194):133–149. [PubMed] [Google Scholar]
  24. Moráin C. O. Acute ileitis. Br Med J (Clin Res Ed) 1981 Oct 24;283(6299):1075–1076. [PMC free article] [PubMed] [Google Scholar]
  25. Nichols G. L., Nicholls M. W. Letter: Colonic involvement in salmonellosis. Lancet. 1976 Jul 31;2(7979):253–253. doi: 10.1016/s0140-6736(76)91047-3. [DOI] [PubMed] [Google Scholar]
  27. Pennington C. R., Bickerstaff K. I., Lyall M. H. Salmonella infection with colitis. J Infect. 1980 Jun;2(2):181–183. doi: 10.1016/s0163-4453(80)91334-1. [DOI] [PubMed] [Google Scholar]
  28. Price A. B., Davies D. R. Pseudomembranous colitis. J Clin Pathol. 1977 Jan;30(1):1–12. doi: 10.1136/jcp.30.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  29. Price A. B., Jewkes J., Sanderson P. J. Acute diarrhoea: Campylobacter colitis and the role of rectal biopsy. J Clin Pathol. 1979 Oct;32(10):990–997. doi: 10.1136/jcp.32.10.990. [DOI] [PMC free article] [PubMed] [Google Scholar]
  30. ROZANSKY R., ROSENMANN E., BEN-ARI Y., STERK V. V. ENTEROPATHOGENIC ESCHERICHIA COLI INFECTIONS IN INFANTS DURING THE PERIOD FROM 1957 TO 1962. J Pediatr. 1964 Apr;64:521–527. doi: 10.1016/s0022-3476(64)80341-3. [DOI] [PubMed] [Google Scholar]
  31. Radsel-Medvescek A., Zargi R., Acko M., Zajc-Satler J. Colonic involvement in salmonellosis. Lancet. 1977 Mar 12;1(8011):601–601. doi: 10.1016/s0140-6736(77)92027-x. [DOI] [PubMed] [Google Scholar]
  32. Ritchie J. K. Results of surgery for inflammatory bowel disease: a further survey of one hospital region. Br Med J. 1974 Feb 16;1(5902):264–268. doi: 10.1136/bmj.1.5902.264. [DOI] [PMC free article] [PubMed] [Google Scholar]
  33. Sharp J. C., Collier P. W., Gilbert R. J. Food poisoning in hospitals in Scotland. J Hyg (Lond) 1979 Oct;83(2):231–236. doi: 10.1017/s0022172400026012. [DOI] [PMC free article] [PubMed] [Google Scholar]
  34. Thompson R. G., Harper I. A. Acute appendicitis and salmonella infections. Br Med J. 1973 May 5;2(5861):300–300. doi: 10.1136/bmj.2.5861.300. [DOI] [PMC free article] [PubMed] [Google Scholar]
  35. WHITE M. E., LORD M. D., ROGERS K. B. Bowel infection and acute appendicitis. Arch Dis Child. 1961 Aug;36:394–399. doi: 10.1136/adc.36.188.394. [DOI] [PMC free article] [PubMed] [Google Scholar]

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